Public Bill Committee

[Mr Gary Streeter in the Chair]

Clause 3

Kerry McCarthy: I beg to move amendment 48, in clause3,page2,leave out lines 26 and 27 and insert—

Gary Streeter: With this it will be convenient to discuss the following: amendment 50, in clause3,page2,leave out lines 26 and 27 and insert—
Amendment 52, in clause3,page2,leave out lines 26 and 27 and insert—
Amendment 46, in clause3,page2,line27,leave out from ‘reached’ to end of line and insert
‘the 12th week of her pregnancy before 1 January 2014.’.
Amendment 44, in clause3,page2,line27,leave out ‘2011’ and insert ‘2014’.
Amendment 49, in clause3,page2,leave out lines 31 and 32 and insert—
Amendment 51, in clause3,page2,leave out lines 31 and 32 and insert—
Amendment 53, in clause3,page2,leave out lines 31 and 32 and insert—
Amendment 47, in clause3,page2,line32,leave out from ‘reached’ to end of line and insert
‘the 12th week of her pregnancy before 1 January 2014.’.
Amendment 45, in clause3,page2,line32,leave out ‘2011’ and insert ‘2014’.
Clause stand part.

Kerry McCarthy: The original intent behind the health in pregnancy grant was to give expectant mothers a one-off grant to help with the costs of a healthy lifestyle, including a better diet in the later stages of pregnancy. I shall come on to the later stages of pregnancy and whether that is the best time for the grant later. I shall also deal with the general issue of whether paying expectant mothers a grant in pregnancy is a good use of public funds, but I wish first to outline the purpose of the amendments.
Amendment 44 and the equivalent amendment 45 applying to Northern Ireland call for the health in pregnancy grant not to be axed in January 2011, but to continue until January 2014. We are pushed for time and will be debating separately amendment 42 tabled by my hon. Friend the Member for Stretford and Urmston, which calls for a full review of the impact of the grant on maternal health before the grant is abolished. Given that it covers much of the same ground, I do not intend to dwell too much on the case for postponing the axing of the grant until 2014, except to make the point that as we are discussing the general benefits of the health in pregnancy grant, its impact and benefit have not yet been fully evaluated. In their evidence, witnesses said that it has more or less been implemented and will be whisked away before anyone has had a chance to assess it—something that amendment 42 would deal with in more detail.
Amendment 46 and its equivalent in respect of Northern Ireland, amendment 47, repeat the call for the grant to be reprieved until January 2014, and would also make it payable to women from the 12th week of pregnancy. That picks up on a point made during the evidence sessions when it was said that the 25th week is too late in a woman’s pregnancy for the grant to be paid and that it would be better if it was paid earlier when nutrition is more important.
Amendment 48, and amendment 49 that would be applicable to Northern Ireland, reiterate the 12-week point, but are open-ended. They would provide for the grant to continue indefinitely rather than there being a 2011 or 2014 cut-off date. They would also introduce an element of means-testing, and link the measure to eligibility for child benefit, which picks up on the criticisms of those who say that the grant should be better targeted towards those who are most in need of the extra money. At the moment, child benefit is a universal benefit, but the Government have announced that they intend to means-test it, albeit in a fairly random way—a point that we shall come to later in the debate. The amendments would build on the notion that despite its somewhat misleading name, the health in pregnancy grant was envisaged originally as an advance on child benefit before the child was born.
Amendment 50 and amendment 51 in respect of Northern Ireland are also linked to the idea of the grant’s being an advance on the child benefit, but suggest that it should be paid monthly as child benefit is currently paid.

Mark Hoban: Will the hon. Lady clarify how much will be paid monthly and for how long?

Kerry McCarthy: If the Minister had been at the evidence sessions or had read the transcript of the proceedings, he would be aware that I asked a witnesses how much they envisaged would be payable. In my opinion, there is a debate to be had about whether the £190 grant should be paid as a lump sum either on the 12th week or the 25th week of pregnancy or whether the same amount should be paid in six monthly instalments or three monthly instalments depending on when it was introduced.

Mark Hoban: I take the hon. Lady’s point about the evidence sessions, but the amendment would create an open-ended commitment for payment of an open-ended amount. Is that really her intention?

Kerry McCarthy: The amendments do not invite a discussion on the amount of the grant. At the moment, it stands at £190. The level at which any payment is set is a separate issue. We are trying to establish the principle of whether it should be paid as a lump sum or divided into monthly instalments, which is something that the witnesses thought might be a good idea.

Mark Hoban: The hon. Lady cannot escape the point about the open-ended spending commitments that she has entered into on behalf of the Opposition.

Kerry McCarthy: I have not done anything of the sort. It is very clear: the amendments are probing, but we are opposing the axing of the health in pregnancy grant. It can therefore be assumed that we think £190 should be paid to an expectant mother. The issue is whether it should be paid in a lump sum, or paid in the 12th week, the 25th week or in monthly instalments. The amendment talks about monthly instalments from the 25th week, but I could have tabled an amendment that said “monthly instalments from the 12th week”, which would have been the same amount but in smaller monthly instalments. That was made clear during the evidence session.

Harriett Baldwin: I am sure the hon. Lady knows that a lot of pregnancies end in the first trimester. I have had miscarriages in the first trimester and even as late as the 16th week. In the case of the benefit having started, does the hon. Lady propose that a woman says, at a time of great trauma, “I have lost my baby”, and the benefit would stop?

Kerry McCarthy: I am very sorry to hear that the hon. Lady had to go through those experiences. That is one of the reasons why my amendment is about payments from the 25th week, because of complicating factors with payments made from the 12th week. In fact, we would have a worse problem if we paid the lump sum at the 12th week and then there was a miscarriage. I cannot think of anything more brutal and horrible than saying to an expectant mother, “We want your £190 back.”

Kate Green: The hon. Member for West Worcestershire raises an important issue about why the health in pregnancy grant is not the same in purpose as child benefit. It is not a payment to an unborn child; it is a payment to support an expectant mother with her health and well-being during pregnancy. I am sure my hon. Friend would agree that we hold on to that important distinction. Our system has never made payments to unborn children. We have to be absolutely clear, and I am sure she will agree with what the grant is about.

Kerry McCarthy: That is a valid point. I will take other interventions and then respond to them all together.

Harriett Baldwin: I just want to clarify what the hon. Lady is proposing. Should the pregnancy end, would the lump sum that is paid in the 12th week have to be repaid?

Kerry McCarthy: I think that doing something like that would be quite grotesque once we have made the payment to an expectant mother. There is an issue with the fact that it is paid in the 12th week, when miscarriages are more likely to occur than in the 25th week. But there are equally valid arguments about the nutritional benefit to the mother. We heard evidence about that, and quite a few people also raised the issue on Second Reading. If the main purpose of the grant is to improve health in pregnancy, the earlier in pregnancy that the grant is made payable and people receive the advice that is linked to the grant—indeed, it is a pre-requisite for accessing the grant—the better.

Harriett Baldwin: Given the difficulties that the hon. Lady admits would occur if her proposals were accepted, would it not make more sense to withdraw the amendment?

Kerry McCarthy: I am not sure which amendment the hon. Lady is talking about. One is about the grant being paid as a lump sum in the 12th week of pregnancy and one is about monthly instalments. We are only nine minutes into the debate and the whole purpose of debating the amendments is to try to thrash out the complexities and whether there are things worth pressing to a Division. Furthermore, my hon. Friend the Member for Stretford and Urmston has tabled an amendment that calls for a full review of the way in which the health in pregnancy grant works. I will happily support her amendment later. A lot of the questions that people will be asking me about my amendments will be thrashed out when we debate the question of the review.

John Hemming: The essence of this matter is that, during the oral evidence sessions, we heard no evidence that the health in pregnancy grant has helped, although I think we all accept that maternal health is crucial, including through getting micronutrients. There is no evidence that the grant has improved maternal health. What evidence is there to justify modifying the grant in either of the ways the hon. Lady suggests?

Kerry McCarthy: The health in pregnancy grant has been in place for only a couple of years, having been introduced in 2009. As with the child trust funds, which we have discussed in the Committee, and with the saving gateway, which has only existed in pilot form, how can the hon. Gentleman say that the grant has not worked? He can say that there is no significant body of evidence that it has worked because it has only recently been introduced. An amendment that we will discuss later calls for a full review of whether it is having an impact. Certainly, the National Childbirth Trust and others provided a fair degree of evidence that was supportive of the health in pregnancy grant. The NCT argued that it would make a real difference to women’s maternal health and the nutrition of their unborn child.

John Hemming: The point about evidence is that the children whose mothers received the grant have mostly been born now, so there would be sufficient information to base such evidence on. However, there is no evidence to justify either the current system or, more important, the changes that the hon. Lady proposes.

Kerry McCarthy: The hon. Gentleman has more or less made the point that maternal health and nutrition are not factors.

Claire Perry: Will the hon. Lady give way?

Kerry McCarthy: No, I want to finish responding on this point.
It can be said of any Government policy that in the very early stages there is not a massive body of evidence or analysis of its impact. The policy needs to be rolled out for a few years so that there is a significant cohort of mothers and children who have benefited from the grant; that takes a while to take hold. The policy was based on the evidence of people working in the field—the NCT, people with medical experience and nutritionists—who thought that more needed to be done to address poor nutrition in pregnancy, and that extra money, which I will come on to, was one way to achieve that goal.

Kate Green: Does my hon. Friend agree that one of the health advantages and long-term outcomes identified by Katherine Rake in her evidence was that the health in pregnancy grant might kick-start a change in family eating habits at a time of transition in family structures and family life? Does my hon. Friend accept that it is far too early to assess the long-term impact of such changes on behaviour?

Kerry McCarthy: I entirely agree that it is far too early to do that. We heard evidence from Anne Longfield from 4Children, who said that particularly those on low incomes—we can come on to whether the benefit should be means-tested or universal—are disproportionately affected by health inequalities. She said that
“a lot of families on low incomes say that they have real concerns about not having enough money to feed their families properly.”
4Children has figures, which the hon. Member for Birmingham, Yardley can ask for if he is interested, that show that
“39% of families on lower incomes say that they worry about not having enough money to get through the week and feed their family. Again, 31% of families say that they do not think that they can afford to provide nutritionally balanced food.”––[Official Report, Savings Accounts and Health in Pregnancy Grant Public Bill Committee, 2 November 2010; c. 72, Q194.]
Anne Longfield also made the point, which echoes what my hon. Friend the Member for Stretford and Urmston has just said, that the grant is about “changing habits”—a nudge to behaviour, which the Prime Minister and his party are reputedly very fond of.

Claire Perry: I thank the hon. Lady for stimulating a lively debate so early in the morning. I know that she was here late last night—until Big Ben struck 10—because I follow her on Twitter. [ Interruption. ]
This debate seems to be turning up many incredibly important matters—maternal health and helping the most disadvantaged families—and all of us, particularly those who have been through pregnancies, would support the need for extremely early intervention in maternal health. That has consequences for improved foetal and child health down the road, which are very important. However, we have moved beyond being able to throw taxpayers’ money at a wall marked good intentions. There was no evidence, before the policy was introduced, that this was the best way to deliver better maternal health. [Interruption.]

Gary Streeter: Order. First, I remind the Committee that interventions are supposed to be brief. Secondly, can we have a little order in how we proceed? It has been a little chaotic this morning.

Kerry McCarthy: I thank the hon. Member for Devizes for her intervention. I place it on the record that I was indeed here at 10 o’clock last night. A certain colleague of hers has said that it is semi-fictional that when she tweets she is in the office.
The hon. Lady makes an interesting point about whether the policy is just about good intentions. However, when it was introduced, it was informed by a body of evidence from the National Childbirth Trust, medical experts, nutritionists, people who work in child health and people who work to address poor nutrition during pregnancy and the early years of the child’s life. There was also a body of work on intervention. She can read the debates that took place when the policy was introduced. It is nonsense to say that it is just about good intentions and that somebody thought it would be nice to give people a bit of money and see how it worked out. She was not in Parliament when the policy was introduced. A body of work was behind the previous Government’s decision.

Paul Maynard: May I try to nudge the hon. Lady, because I do not follow her argument? Does she believe that the health in pregnancy grant functions as it should with the current point of payout? If so, why has she tabled amendments to advance the date of payout to earlier in pregnancy? If she does not believe that the grant is performing its function at the current point of payout, why is she trying to defend the principle? If the grant is not achieving its principal goal of improving maternal health, why is she defending it? She is hoist by her own petard.

Kerry McCarthy: The problem is that these amendments have been grouped together. That is beyond my control. I would rather have dealt with each issue separately so that we could debate just whether the payment should be moved from the 25th week to the 12th week. That is a valid criticism, which was raised by Government Members on Second Reading and by witnesses. However, that we think there should be a debate on moving the payment to the 12th week does not mean that we think it is completely ineffective at the 25th week. We received evidence from witnesses that the money could be put to other uses at the 25th week, and that it was valued by recipients. Unfortunately, because of the grouping of the amendments and because hon. Members have intervened on me so early, we are having a debate about the 12th week issue, means-testing and the efficacy of the grant all in one, which makes life rather confusing.

Sarah Newton: I return to the hon. Lady’s point about the evidence when the measure was introduced. I have read the reports, and a huge body of evidence was given to the then Government showing that the grant would not achieve its aim, which was to improve the health of the mother during pregnancy and the health outcomes of the baby. It was demonstrated clearly that the grant would be given too late and would not deliver its purpose.

Kerry McCarthy: That leads to the issue of whether it was seen as an advanced child benefit. The 25th week was seen as administratively easy because women go for their antenatal appointment at that time if it is their first child, or a little later if it is their second. There is a debate to be had about whether the date should be moved forward. I am happy to put the amendment on moving the payment to the 12th week to a vote. However, I think that people have used the argument about whether it would be more effective at that date to suggest that it is ineffective at the 25th week, and I refuse to concede that. We have received substantial evidence to suggest that it is useful. People might use it for things that do not relate directly to health in pregnancy, for instance lump-sum payments on items such as buggies, but the fact that they have to get into the system and receive advice from a specialist before they can access the grant is important. I am happy, as I have said, to push the 12-week issue to a vote. However, I think that certain members of the Committee are using it as a spurious reason to reject the whole of the grant. If Government Members think that the grant would be a good thing if it was paid earlier, they ought to vote for it to remain but to be paid in the 12th week, rather than vote to axe it altogether.

Harriett Baldwin: This really should be called the baby bonus grant, or something like that. Who would not like £190 in their seventh week of pregnancy? It should not be called the health in pregnancy grant. Netmums has submitted evidence from 111 mums, 65 of whom say that the grant is a big waste of money and is spent on things such as clothes and Butlin’s. That is the feedback from the people who have received the grant.

Kerry McCarthy: That is not a particularly scientific sample. It was given as evidence, as was a whole bundle of other statements from people who think that the health in pregnancy grant is a good thing. I have talked to Mumsnet, partly because I was concerned that people seemed to think that Netmums and Mumsnet were the same organisation. The Minister seemed to think that that was the case in a conversation we had before an earlier Committee sitting. Mumsnet was going to send me some information, but it has not arrived in time for today’s sitting. As I understand it, Mumsnet would take a very different view on the matter. Netmums obviously has a certain audience who comment on its website. It is a valid view and worth taking into account, but to cite it as somehow more compelling than the evidence of experts working in the field might be wrong.

Yvonne Fovargue: Does my hon. Friend agree that our discussions have so far concentrated only on physical health in pregnancy? Mental health is also important during pregnancy, and the £190 payment is invaluable in relieving some of the stress that mums feel, which is bad for them and for the baby, during a difficult time of their lives.

Kerry McCarthy: I agree with that valid point. It is addressed by amendment 42, which we will discuss later.

Mark Hoban: I want to help the hon. Lady clarify her argument. The 10 amendments in the group represent five different options. Will she tell us which pair of amendments she proposes to put to a vote, so that we can focus on the strongest point of her argument?

Kerry McCarthy: That is a matter for us to decide upon once we have heard the debate. As I have said, I am happy to put the 12-week amendment to a vote, because it seems to have some support from Government Members. Although we are constrained for time, there is still a healthy debate to be had before we decide which amendments to put to a vote.
Before all the interventions, I had just said that amendment 50 deals with monthly instalments. Amendments 52 and 53, which relates to Northern Ireland, propose changing the grant to monthly instalments, but they also add a means-testing element by linking it to child benefit.
The main issues under discussion today—some of which we have already addressed in some detail—are whether the health in pregnancy grant is useful and a good use of public money in constrained economic times; whether it would be better to pay it from the 12th week of pregnancy, not the 25th; whether it should be paid in a lump sum or in monthly instalments; and whether it should be targeted and means-tested along the lines of child benefit, or remain a universal benefit. I have resisted the temptation to go down the path suggested by another strand of criticism during previous debates.
 Paul Maynard  rose—

Kerry McCarthy: May I continue for a moment? It is important to set the parameters of today’s debate, because the interventions have taken us off track slightly. One of the criticisms raised on Second Reading—it also reared its head during the evidence sittings—was that the health in pregnancy grant could be spent on anything. The Netmums evidence also referred to the idea that there is no control over it. On Second Reading, there was an unpleasant suggestion that women could not be trusted to spend such money in the best interests of their own health during pregnancy, or in the nutritional interests of their unborn child. It was suggested that they would squander the money, and there was a reference from the Netmums evidence that somebody spent the grant on spa treatment.
Using anecdotal evidence about the behaviour of a few people to negate the evidence of benefit to the many is becoming an endemic problem with this Government. In the arguments on the housing benefit cap, only three families were identified as falling into the category of receiving more than £100,000 a year in housing benefit. The DWP press officer asked for examples of people who were raking in thousands and thousands of pounds in housing benefit and was told that the Department did not have statistics—[Interruption.]The Chairman is quite capable of telling me if I have gone off the topic, and I am about to conclude that point. When the DWP was asked for evidence of people with excessive housing benefits claims, it said that it did not have statistics, but if people looked at the Daily Mail or The Sun websites they would find plenty of stories about that. We are falling into the trap—[Interruption.] My point is that we can always find anecdotal evidence that some people are not using the money for its intended purpose.

Claire Perry: Will the hon. Lady give way on this point?

Kerry McCarthy: No. Such evidence does not constitute an argument to axe the grant completely for the vast majority of people who will spend it wisely and well.
During evidence, we heard that most women on limited budgets—my hon. Friend the Member for Stretford and Urmston will recognise this from her days of working at the Child Poverty Action Group—will value that grant and put it to good use. The argument that the money could not be controlled and might be spent on the wrong things is spurious. It was put forward as a way of trying to negate the point of the health in pregnancy grant and was an example of throwing something at the wall to see if it sticks.

Paul Maynard: Will the hon. Lady give way?

Kerry McCarthy: I want to make some progress and move to the general issues.
During evidence, I did not hear anybody say that the grant should be replaced by vouchers. If people believe that it is being spent on the wrong things, why do they not table an amendment that proposes a replacement by vouchers instead? We would not support that, however. The Minister mentioned the Healthy Start scheme vouchers, which the Government were quite keen to get rid of until there was a public outcry about the milk vouchers—I may be wrong—[Interruption.] The Minister confirms that he is committed to the Healthy Start scheme, which I am glad about. I would not support the argument that the scheme be replaced by vouchers, but it would be a valid stance to take.
On the general benefits of the scheme, I refer to a submission from the Zacchaeus 2000 Trust, which states that unemployment benefit for a single woman before she gives birth is £51.85 a week; the minimum income food standard, which I believe the Joseph Rowntree Foundation researched, is £44 a week. We will return to that when we discuss amendment 42, but the fact is that there are many people living on low incomes, who cannot afford to meet their nutritional needs during pregnancy, nor those of their unborn child.
I want to discuss means-testing, but I shall give way to the hon. Gentleman.

Paul Maynard: I thank the hon. Lady for recognising my persistence. To help clarify: when she argues that the health in pregnancy grant is useful, what definition does she apply to the word “useful”? What is her evidential threshold for demonstrating use? It is important for Government Members to understand her argument and how she defines the concept “useful” in relation to the grant.

Kerry McCarthy: The grant works on several levels at present. It brings people into the system to get advice at the 25th week.

Claire Perry: Where is the evidence? How many?

Gary Streeter: Order. I am not sure what hon. Members have had for breakfast this morning, but there are too many sedentary interventions and there is too much background conversation.

Kerry McCarthy: I think that it is the job of the party in Government that is making the case for axing the grant to provide evidence that it does not work.

John Hemming: The hon. Lady says that it is the responsibility of the Government to prove that the grant does not work, but that is an impossibility. It is the responsibility of those who believe that the grant works to prove that. There is no evidence that it works. Proving the negative is difficult.

Kerry McCarthy: I do not accept that. Before the Government rushed into this policy, and those on the saving gateway and the child trust fund, they should have presented a more coherent case. There should have been a proper, full consultation on whether the health in pregnancy grant, and other measures, were working.

David Hanson: Will my hon. Friend confirm whether there was a formal consultation on the abolition of the health in pregnancy grant? The Minister could not be bothered to turn up to the evidence sessions and there has been no formal consultation. The Government’s evidence is based on a few e-mails from Mumsnet—

Kerry McCarthy: Netmums.

David Hanson: —and Netmums, and nothing else.

Kerry McCarthy: That is exactly the case. We are getting to the stage where we are dancing on the head of a pin, but there should have been a full consultation. The Government should push back the date of the abolition of the grant to 2014, as in the amendment. We need more time to see whether the scheme works. To return to the intervention by the hon. Member for Blackpool North and Cleveleys, the fact that the provision brings people into the system to get maternal advice is important. It has provided a boost to people’s incomes that they can spend on a better diet, or on other things that they may need during the later stages of pregnancy. That is also important. People who work in the field say that the grant is incredibly valuable and should not be taken away.
There is some ideological confusion from the Government on the question of universality and means-testing, especially when it comes to implementing policies. The Government argue that one of the problems with the grant is that it goes to everybody, regardless of income, and therefore it inevitably goes to some people who do not need the money and who spend it on frivolities, as the Netmums evidence showed. I am not sure where that leaves the Government on other universal benefits such as the winter fuel allowance. Some pensioners in receipt of that are in the same position, but we do not have time to go into that matter today.
Two approaches can be taken to means-testing. The first is to restrict the grant to people on benefits who receive Healthy Start or Sure Start support during pregnancy. The other is to link the grant to child benefit, as in the amendment. The coalition Government want to means-test child benefit. They argue that child benefit is not needed by the better-off and that the money could be put to better use, primarily in paying off the deficit. That point is arguable, but it is not something that the Labour party supports. It is a reasonable enough stance to take, except for the fact that the Government have got themselves into a mess on the issue of child benefit. The way that they have introduced means-testing for child benefit means that a household with one earner on more than £44,000 a year would not be eligible for child benefit, whereas a household with two people who earn £40,000 each would be.
The amendment links the means-testing to the reforms to child benefit, but that should not be seen as an endorsement of what the Government are planning to do with child benefit. We think that it is a muddle and that the Government have got themselves in a mess on the issue of independent taxation and we would not endorse the measure along those lines. However, because the health in pregnancy grant was originally intended as an advance form of child benefit, that is the easiest thing to link it to.
Let me also make it clear that our preferred option is that the grant should not be means-tested and that it should continue as a universal benefit. However, because so many Government Members were arguing, during the evidence session and on Second Reading, that the fact that the grant was not targeted was a problem, we wanted to use this amendment to tease out whether they would be happy to accept it if it was a more targeted form of benefit.
Alternatively, we could have suggested that the grant was simply added to the Sure Start maternity grant, which is a one-off payment to people on certain benefits to meet the cost of their new baby. That grant has now been abolished for second and subsequent children and is only for a first child. Adding the health in pregnancy grant to the Sure Start maternity grant would be quite easy to administer and therefore we would not have the problems of trying to unpick the mess that surrounds what the Government are trying to do on child benefit. However, it would mean that the £190 would go only to those people in receipt of those particular benefits, which is obviously a much smaller group of people than those who would be entitled to means-tested child benefit when it is introduced.
In the evidence session, the representative of the National Childbirth Trust thought that the health in pregnancy grant should be linked to child benefit at 12 weeks. She thought that it was quite important that the grant should not just reach the women on very low levels of income who suffer from poor nutrition, but that it was also important that it should reach women on the next level up. Obviously, linking the grant to child benefit also fits in with the original intention that the grant would in effect be child benefit in advance, which several witnesses endorsed as a good concept.
We have already touched on the issue of whether the grant should be paid as a lump sum or in instalments. We heard evidence that lump sum payments can be useful, but we also heard evidence that smaller and more frequent payments might be more likely to be spent on food and nutrition. It is arguable that if someone receives a lump sum, particularly later in the pregnancy, it might be more likely to be used for something such as a buggy, although for people on very low incomes there are other grants that might be available, for example the Sure Start maternity grant, for such things. At least one witness said that if the health in pregnancy grant was paid in instalments, it would be more likely to be used to meet the weekly food bill and therefore it might have more of an impact on food and nutrition. The Institute for Fiscal Studies said that there was a case for either approach. Belinda Phipps from the NCT said that both approaches were needed and that parents struggle in both respects. I would be interested to hear what other people think about this issue.
I have already addressed the issue of whether payments should be brought forward to 12 weeks. I reiterate the point that because one of the advantages of the grant is that there is a precondition that women must seek advice on maternal health matters from a health professional before they are entitled to receive it, bringing the date forward to 12 weeks obviously means that they would access that advice much earlier, which could be significant.

Harriett Baldwin: I really would encourage the hon. Lady just not to go there with these amendments. So many people lose babies in the first trimester. I think that the estimates are that one in three pregnancies end in the first trimester and people will know very many people who have had miscarriages in the first trimester. Just let us not go there.

Kerry McCarthy: That is a valid point for debate. However, this issue was consistently raised by people on Second Reading. I think that the hon. Member for Birmingham, Yardley has raised it at various times. It also came up during the evidence sessions. It is arguable whether we should look at the 12th week, the 16th week or whatever, but I think that it is certainly worth having a debate on this issue because so many people are saying that this grant is not of value because it is paid at the 25th week and therefore too late in pregnancy. Consequently, it is important that we have a debate about whether we can pay the grant earlier rather than axing it altogether and saying that it is a bad thing. Nevertheless, I accept that the issue of when the grant should be paid is a very difficult and sensitive one, because there will be women who lose babies around that earlier time. If the hon. Lady wanted to propose an amendment on Report setting the date of payment at 16 weeks or 20 weeks, that might be quite a valid thing to do.

Harriett Baldwin: Perhaps the hon. Lady would go a bit further and recognise that the idea of payment at 12 weeks would no doubt have been debated when the original legislation was brought in; that no doubt it was rejected for the reasons that we have found so easily this morning, and that to pay this grant in the seventh month, when the baby is viable, is a plausible timing, but means that this is more a baby bonus rather than a health in pregnancy grant.

Kerry McCarthy: Perhaps the fact that it is called the health in pregnancy grant is a slight misnomer, but I do not think that that invalidates the whole purpose of making the payment. The reason why it is called the health in pregnancy grant is that it is linked to the requirement to seek health advice in advance, but I think that is a separate issue from whether the money is spent on those issues.

Alison McGovern: Does my hon. Friend agree that if the best change required to the grant was to maintain but rename it, it would be a relatively straightforward amendment to table on Report?

Kerry McCarthy: I entirely agree with my hon. Friend. Given the time and the fact that we have to break at 10.25 am, I will conclude my comments there, and look forward to hearing what other people have to say.

Sheila Gilmore: Having listened to the points made at the evidence sessions and on Second Reading by people sitting in this Room on the Government Benches, it seems to me that it is now cavalier to simply say, “Well, all these amendments are ridiculous. We just need to abolish this,” because the amendments address issues that have been raised—not necessarily ones with which I fully agree, because there are problems with various suggestions. I take the issues raised by the hon. Member for West Worcestershire about the difficulties that could arise before the 12th week of pregnancy; it is a fair point to debate and consider. There are also issues about means-testing, because, after all, one of the problems is that for those who are just above means-tested levels, whatever they are, there can be considerable resentment and difficulty. Those who are enthusiastic about targeting benefits on those who need them most have to realise that there are substantial issues with doing that that disadvantage another group of people.
We have heard, both in the evidence sessions and from Government Members, a number of good suggestions and reasonable criticisms of the payment as it was originally structured. I am disappointed to hear so many negatives now being raised to the same points—at least it appears to me to be so—that the same hon. Members were espousing previously. That brings us back to the point that I hope we will debate shortly, which is that to address the matter in such a way right from the start and simply say, “Here are a few benefits that we do not like. We will just score them off,” without looking at it in the round, is exactly what is getting us into this position now where we cannot necessarily weigh all the evidence. We heard some compelling evidence from the witnesses who attended on the importance of the payment, and we have heard other evidence from some who felt that the payment was poorly targeted. It is, in my view, a case for looking at the matter in greater depth.

Mark Hoban: We have had a helpful debate on the topic. The speech made by the hon. Member for Bristol East demonstrates some of the challenges of the grant. It is described as a health in pregnancy grant, but it is not linked entirely to health in pregnancy because it is paid too late. It is a lump-sum payment, and there is no requirement or stipulation on how it should be spent. Of course, the justification goes back to health, but there is no evidence about how that works. The right hon. Member for Delyn asked why there was no full consultation on scrapping the grant. I gently point out to him that there was no consultation on its introduction either. If there had been some consultation or evidence gathered about its effectiveness, perhaps Opposition Members would have been better placed to defend it.

Kate Green: As somebody who was in the lobbying side of the world shortly before, and when, the grant was introduced, I can assure the Minister that there were lively debates between Ministers and the Child Poverty Action Group, which I then led, as well as between Ministers and many other children’s organisations. Those discussions were about the best way of supporting women in the course of pregnancy, with a particular focus on the financial side. While there may not have been a specific consultation, I can assure him that there was an extensive discussion beforehand.

Mark Hoban: I am sure that there was and I am sure that that extensive discussion probably led to two of the measures that we do support—the Sure Start maternity grant and the Healthy Start vouchers. Those are very different from the measure before us.

Alison McGovern: I want to check whether the Minister is proposing that all similar grants, which may or may not—because they are not restricted in the way that vouchers are—be spent on the thing that they appear to be designed for, ought to be renamed across government, including the winter fuel payment.

Mark Hoban: Rebadging was a sign of the previous Government’s desire to say, “If it doesn’t work, let’s change the name of it and see if it works then.” That is not the argument that we are making. We are saying that this does not work, it is not effective, it is not targeted and therefore we should simply scrap it, rather than spending money to rebrand it. The right hon. Member for Delyn has mentioned a number of times in the Committee that I did not attend the evidence sessions. I want to point out to him that Ian Pearson, my predecessor in this role, never attended evidence sessions on the Financial Services Bill, or indeed on the Savings Gateway Bill, other than to give evidence himself.

David Hanson: All I will say in response to that is that in every Bill that I saw through Committee as a Minister, I attended every session, asked questions of the witnesses and listened to the evidence myself. I hope that he would match those standards for the convenience of the Committee. While he is talking about consultation, may I ask him whether he suggested to the electorate in the big consultation that took place 6 May this year that he would scrap the maternity grant?

Mark Hoban: I know that the right hon. Gentleman is keen to keep us to our manifesto promises, but it is clear in this case that taxpayers’ money is not spent effectively. In looking at the financial position that we inherited, the right thing to do is to examine carefully where money is spent and what we can do to ensure that that money is spent more carefully. Is it better to spend it in this way, or should we tackle the deficit by reducing spending here? That is the choice that we made, and I am happy to stand by that choice.

Kerry McCarthy: The Minister has said several times that it is not working and there is no evidence that it is of any use—I paraphrase his comments, but that is the gist. Can he quantify that? Can he justify that? Can he say why he has that opinion? What has led him to conclude that this is not working?

Mark Hoban: It is not working. The arguments put forward by Labour Members are about health and targeting support, yet the reality is that, as we have heard in the evidence sessions, support for maternal health should be given earlier in pregnancy, not later. The payments are not linked to health. The lump sum is available to be spent in any way people choose. We know that people choose to spend it in different ways. This grant does not deal with the issue that the hon. Member for Stretford and Urmston raised. There are other mechanisms that do that, and they work more effectively.

Kerry McCarthy: Will the Minister give way?

Mark Hoban: I am happy to give way. The hon. Lady is generous in giving way herself, so I will be equally generous to her.

Kerry McCarthy: The Minister has made two points. The first was that the grant would be more effective if it was paid earlier, in which case the route to go down would be to examine whether it would be effective if it was paid at 12 weeks or at a different point ahead of 25 weeks. He also said that it was not linked to health and that other schemes such as the Healthy Start vouchers were more effective. Those vouchers, however, are available only to those on very low incomes. Does the Minister think that this £190 should be additional money for those on low incomes, because they will be losing out on the £190? Alternatively, does he think that the Healthy Start scheme should be extended, so that the vouchers are available to those on higher incomes? He seems to be saying that the Healthy Start voucher scheme is a good thing, if we are taking away the health in pregnancy grant because the grant does not work in the right way. Should that scheme be extended instead?

Gary Streeter: Order. Let us make sure that we are not about to have a Second Reading debate.

Mark Hoban: The schemes are targeted, and that is important.
Abolishing the health in pregnancy grant will help to reduce the United Kingdom’s deficit. It will save £40 million this year and £150 million per year thereafter. As I said on Second Reading, there are better ways to spend the money and, having decided that, we need to abolish the health in pregnancy grant. The Government believe that that should be done quickly to maximum Exchequer savings, so delaying abolition to 2014, as amendments 44, 45, 46 and 47 would do, would mean reducing those savings. If that were not done, additional money would have to be found through other spending cuts, borrowing or tax rises. The hon. Lady did not say how she would provide money for that.
Amendments 48, 49, 52 and 53 would make eligibility to the health in pregnancy grant contingent on child benefit. That remains universal until January 2013, so the health in pregnancy grant would not be targeted effectively on those who need support in pregnancy, as it would remain universal until that time. In any case, the Government’s most urgent task is to reduce the UK’s budget deficit, and hard decisions have to be taken based on what the country can afford to spend. Exchequer savings from abolishing the grant would be reduced significantly if some mothers remained eligible or if it were paid earlier in pregnancy, as amendments 48 to 53 would do.
Amendments 44, 45 and 50 to 53 would mean that the health in pregnancy grant continued to be payable from the 25th week. There is no doubt that maintaining a healthy diet throughout pregnancy is important. However, as Belinda Phipps of the National Childbirth Trust said in an evidence session:
“If you are setting out primarily to improve the nutrition of the mother to improve the health of the baby,
the payment of a health in pregnancy grant needs to be earlier. She continued:
“But if you really want to change the future of the baby, it needs to be as early as possible. It is not possible easily to do it pre-conception, but the earlier in pregnancy you can do it, the better.––[Official Report, Savings Accounts and Health in Pregnancy Grant Public Bill Committee, Thursday 4 November 2010; c. 79, Q205.]
Keeping the grant in place and continuing to pay it from the 25th week would still mean that it was unfocused.

Kate Green: I want to take the Minister back to the universality point. Will he comment on the evidence of Katherine Rake, who said that poverty and financial need is not a static state, and that the experience of going through pregnancy and childbirth into motherhood is a time when women are critically at risk of moving into poverty. That is the argument for the universal payment, and I should be interested to hear the Minister’s comments.

Mark Hoban: Opposition Member are advancing a range of arguments. Some say that the payment should be targeted. That is the basis of the amendments tabled by the shadow Minister. However, others are saying that the payment should be universal. Given the financial crisis facing this country at present, we cannot afford universal benefits that are ill-targeted.

Kerry McCarthy: Will the Minister give way?

Mark Hoban: I want to make some progress. Amendments 44, 45, 46 and 27 would make the grant payable from the 12th week and therefore earlier in pregnancy. However, it would still be a lump-sum cash payment and, as Dr Callan of the Centre for Social Justice said in an evidence session:
“There was absolutely no guarantee that the grant would be spent on nutritious food.”––[Official Report, Savings Account and Health in Pregnancy Grant Public Bill Committee, 4 November 2010; c. 116, Q279.]
Furthermore, as I said earlier, the Government are committed to supporting the health of pregnant women in low-income households through the Healthy Start scheme, which provides support from the 10th week of pregnancy when diet is particularly important in a baby’s development. The scheme provides vouchers worth £3.10 a week for fruit, vegetables and milk, as well as coupons to exchange for healthy start vitamin supplements containing the recommended daily amounts of vitamins C, D and folic acid, for pregnant women and new mothers. It provides a nutritional safety net and encouragement for breastfeeding and healthy eating to more than half a million pregnant women and children under 4 years old in low-income and disadvantaged families throughout the UK. As Belinda Phipps said during the evidence sessions,
“Healthy Start is a really good scheme…It has been put together well and people can get a broad range of healthy foods for the vouchers.”––[Official Report, Savings Accounts and health in Pregnancy Grant Public Bill Committee, 4 November 2010; c. 89, Q224.]

Claire Perry: The Minister is bringing up a very important point. We have heard incredibly good evidence from some Opposition Members, particularly the hon. Members for Makerfield and for Stretford and Urmston, about the importance of making sure that the nutrients are available. Will my hon. Friend consider talking to his counterparts at the Department of Health to find out what more can be done to help health visitors and midwives to ensure that such health benefits reach those women who need them most?

Mark Hoban: I am always wary of giving advice to colleagues in other Departments, but I am sure that my hon. Friend will put that point to the Department of Health. It is important that mothers access the support that is available. Advice is available for expectant mothers from health visitors and at hospital appointments. That advice deals with some of the issues that Opposition Members have raised about stress and better diet. Opposition Members should remember the schemes that are in place to provide support for expectant mothers.

Alison McGovern: Will the Minister give way?

Mark Hoban: No, I will make some progress.
My hon. Friend the Member for Devizes spoke about the Department of Health. That Department is currently co-ordinating a consultation on the extension of the scheme that provides vouchers to buy plain frozen fruit and vegetables. That would increase the flexibility and choice for women supported by Healthy Start and encourage them to include more fruit and vegetables in their daily diet at the time in their pregnancy when it is particularly important.
The Government have faced difficult choices on where to cut public expenditure. We cannot afford to continue spending £150 million a year on a cash payment for the health in pregnancy grant, which is paid regardless of what it is spent on and of the income or financial position of the recipient. I believe that we should go ahead with the abolition of the grant. I do not believe that we should maintain it or pay an equivalent amount in monthly instalments. It is not even clear how long that would go on for under amendments 50, 52 and 53. I do not believe that we should make it payable from the 12th week, as under amendments 46, 47, 48 and 49. Having decided that we need to abolish the health in pregnancy grant, the Government believe it is best to do so quickly to maximise the savings to the Exchequer.

Kerry McCarthy: Is the Minister’s criticism of the amendments that would introduce monthly instalments that they would leave the Government open to paying the instalments after the child is born? It is clear that the £190 would be divided into monthly instalments until the birth, when child benefit would take over.

Mark Hoban: That is not my only objection to the amendment, but it does not say that. I have made it clear that we need to scrap the grant to tackle the financial deficit. Other schemes are in place to improve maternal health during pregnancy. The measures that the hon. Lady has tabled would continue the payment, but change the time of the payment. I do not think that they would address the main issues. I therefore encourage her not to press the amendments.

Alison McGovern: I want to make a few brief points about the amendments and to respond to the points that have been made.
My hon. Friend the Member for Makerfield said that health was broader than nutrition, and that bears repetition. Perhaps the debate that took place when the measure was introduced did focus on micronutrients. As the daughter of a long-standing breastfeeding counsellor for the National Childbirth Trust, I am well aware of the importance of breastfeeding. Costs in pregnancy include the purchase of items such as breast pumps, and the NCT provides a wonderful service in ensuring that such items are available. We need to consider the broad spectrum of health aspects. My hon. Friend rightly mentioned mental health. I recall in the evidence sessions hearing about women who took their grants to NCT nearly new sales.

Gary Streeter: It would be helpful if the hon. Lady linked her remarks to the amendments that we are considering.

Alison McGovern: I am sorry, Mr Streeter. I was just coming to that.
I welcome the amendments because they probe into how we can better support health in pregnancy. In his response, the Minister said that he would oppose the amendment because the country could not afford the grant at this time. However, it is important for us to consider what alternatives will remain if the grant is removed. He made it clear that the Sure Start maternity grant and Healthy Start vouchers would remain if the amendment was rejected and the health in pregnancy grant removed. That is a welcome commitment, and if the Minister had allowed me to intervene—he did not because he did not have time, which is fine—I would have asked him to place his commitment to those provisions on the record. There is the fear, certainly among my constituents, that we are seeing a slow but sure cutting away of facilities for families. It is important to know the Government’s intentions towards other things that supplement the health in pregnancy grant.
We can debate the timing and look at what approach should be taken to support mothers, but it is important to consider the whole package of measures, as the Minister indicated that he had done in opposing the amendment. Perhaps I can assume this from the remarks the Minister has already made, but I would be grateful if he would confirm that the Government are absolutely committed to the Sure Start maternity grant and Healthy Start vouchers.

John Hemming: This is an example of a nice idea of giving people a bit of extra money without any evidence that it helps. Everybody would like to give people a little extra money. Perhaps we could do that every month, as suggested by the amendment. That would be nice—£190 a month. It is a nice proposal, but I wonder whether it has been cleared with the shadow Cabinet.

Kerry McCarthy: Nobody is suggesting £190 a month. I made it clear in my remarks that it would either be a lump sum of £190, or that the £190 would be split into monthly instalments. If it were split over three months, it would be just over £60 a month.

John Hemming: It is a question of to what extent Pepper v. Hart is relevant. The interpretation of statute starts with the words in statute. Pepper v. Hart was a case involving the Revenue and it allowed consideration of discussions to be brought into that. However, the words are quite clear and the word “split” does not appear in the amendment. I recommend that the Opposition withdraw that amendment. It is so badly phrased that it is a massive financial commitment.
The underlying point is that if one is to implement policy, there should be evidence—not opinion—to justify the policy. This policy has been in place for two years, but there is no evidence that it works. The Government have to focus on things that achieve results. Good maternal health prior to conception, during pregnancy and post-birth, is important for the health of the child. However, there is no evidence that the grant works, and we have to cut some things.

Alison McGovern: The hon. Gentleman rightly focuses on evidence. However, the life of the grant has been fairly short. If we look at some of the research into child health, we might expect to see the effects of the grant come about when the child is taking their GCSEs, for example. How does that sit with the hon. Gentleman’s point?

John Hemming: As a child moves further away from birth, it gets very difficult to link cause and effect. For example, birth weights can be, and are, measured. Obviously, a number of mothers who received the grant are likely to have given birth. Potentially, we have the ability to collect evidence and prove that the grant has worked.

Kate Green: Does the hon. Gentleman know whether the Minister has collected that evidence?

John Hemming: We should understand that the Opposition were in government until May this year. The scheme was introduced in 2008—I do not know exactly when, but it definitely ran for over a year, possibly two years.

Kate Green: With respect to the hon. Gentleman, I do not think that the Labour party had any intention of abolishing the scheme in short order. There would have been time to set up a proper evaluation programme and evaluate the evidence over time.

Gary Streeter: On the amendments.

John Hemming: On the amendments, basically, there is no evidence that the grant works.

David Hanson: Will the hon. Gentleman remind me whether the Liberal Democrats and Conservatives opposed the introduction of the grant at the time? Just remind me.

John Hemming: It is fair to say that you should evaluate something after it has gone in, and there should be evidence after—

David Hanson: Will the hon. Gentleman just remind me whether the Liberal Democrats and the Conservatives opposed the introduction at the time? Could he remind me of that fact?

John Hemming: I am going by the probably better knowledge of the Opposition spokesman on this matter. We probably supported it when it came in, but now that there is no evidence that it works, we think it is a good idea to get rid of it.

Kerry McCarthy: Has the hon. Gentleman finished his speech?

John Hemming: If the hon. Lady would like to intervene, it is with Mr Streeter’s permission.

Gary Streeter: Order. Has the hon. Gentleman finished his speech?

John Hemming: I had finished my speech.

Gary Streeter: I call Kerry McCarthy to wind up on her amendments.

Kerry McCarthy: I start by making the point that I was going to make by way of intervention to the hon. Member for Birmingham, Yardley. His argument is entirely inconsistent. On the one hand, he is saying that there is no evidence that the grant works, and therefore one should not have the policy in place. On the other hand, although his memory is quite hazy, I think he has conceded that the Liberal Democrats supported the introduction of the health in pregnancy grant—

Mark Hoban: If I may help both the hon. Lady and my hon. Friend the Member for Birmingham, Yardley, his colleagues prayed against the introduction, as did my right hon. Friend the Member for Hitchin and Harpenden (Mr Lilley).

Kerry McCarthy: I thank the Minister for giving that clarification. It is good to know that he knows better than his coalition partners what they have done in the past. However, the hon. Member for Birmingham, Yardley seemed to concede that it would have been okay for him to vote in favour of the grant if he had done so, which he has not. If he had done so, it would have been perfectly legitimate for him to do so, on the basis of insufficient evidence that the grant would work in practice.

Kate Green: Does my hon. Friend accept that one of the benefits of the grant highlighted by Dr Katherine Rake in her evidence to us last week was that it was intended in part to change long-term dietary habits? It would have been impossible to have evaluated that in the first 12 or 18 months after its introduction.

Kerry McCarthy: I entirely agree. We have heard quite a lot from some of the people who surround the coalition Government about the importance of changing behaviour and about people taking responsibility for their lives. The whole idea of the big society is that we want to get away from the nanny state and we want people to be empowered and nudged, if you like, to make decisions on their own accord. The fact that it was linked to advice from a health professional—it is not just about the money—fits entirely with the Government’s agenda that people sometimes need a little bit of nudging, but the benefits far outweigh the outlay on the initial policy.
I know that the hon. Member for Birmingham, Yardley is not here to answer questions—certainly not at this stage, now that he has sat down—but as far as I am aware, and I am sure that the Minister knows this better than I do, there was no commitment in the Liberal Democrat manifesto to axe the policy.

Mark Hoban: If I can help, there was.

Kerry McCarthy: Obviously, on this side of the Committee Room, we need to do our homework on the Liberal Democrats slightly better, so that we can confirm that they went into the election with the promise to axe child trust funds and the health in pregnancy grants, and with a promise to say no to student fees, but we will gloss over that one.

John Hemming: That is not accurate, but obviously we do not want to debate that. The essential point that I was making, which the hon. Lady sought to respond to by intervening on me, was that there is no evidence that it works.

Gary Streeter: Kerry McCarthy, on the amendments.

Kerry McCarthy: That is something that I think we will come on to when we discuss amendment 42 in more detail, as that calls for a thorough review. The relevant statutory instrument came into force on 21 July 2008, and parts of it came into force on 1 January 2009. It is a very new policy.

Claire Perry: To the hon. Lady’s knowledge, did the previous Government put in place a process to gather evidence that might suggest the policy works? I believe that more than 500,000 women will have given birth in receipt of the grant. Is there any evidence-gathering process to see whether the policy has any impact on the aims it was designed to achieve?

Kerry McCarthy: It is certainly something that—

Claire Perry: Yes or no?

Kerry McCarthy: I am not aware of any. I was not a Treasury Minister in the previous Government. I was not involved in the introduction or implementation of the policy. From my experience in other Departments, I know that it is par for the course. If we introduce a new policy, we have mechanisms in place. Certainly, when the Department for Work and Pensions introduces new policies, there is an ongoing process of evaluation, consideration and consultation to ensure that it is doing the right thing.

David Hanson: Will my hon. Friend suggest that the Minister accepts the amendment that allows us to progress until 2014 to give us an opportunity to make that evaluation before he abolishes the grant?

Kerry McCarthy: I was about to come to that point. The amendments that extend the date from 2011 to 2014 would provide such an opportunity. Rather than saying on the basis of no evidence that it does not work, we are saying that there is significant evidence from professionals that it would be a good thing to continue. We do not have quantitative evidence based on the actual outcome of it having been introduced, because it is in its early stages, but we need breathing space to be able to do that work. The amendments calling for the date to be changed from 2011 to 2014, and amendment 42, which we will come to, allow us that breathing space. That is better than rushing to axe things in the interests of reducing the deficit. We could have a separate argument about whether the Government are rushing too fast and the damage that that would cause, but I am sure Mr Streeter will rule me out of order if I venture down that path.

Kate Green: Does my hon. Friend not also agree that in addition to any calculation about the impact on the deficit in the short term, the Government should be considering the long-term costs to society of the risk of more babies being born with low birth weight and poorer long-term health and education outcomes, and indeed, as was alluded to by some witnesses, at greater risk of falling into anti-social and criminal behaviour?

Kerry McCarthy: My hon. Friend makes a valid point. Some interesting studies have found that changes to the diet of young offenders, even when they are adults, can have a significant impact on their behaviour. A lot more work needs to be done on whether poor nutritional standards early in life have a knock-on effect. As my hon. Friend says, it is important not to jettison policies that are linked to the early intervention agenda. Indeed, if we consider pregnancy and pre-conception, Katherine Rake gave evidence and said that some of her colleagues, who are perhaps more middle class than the people we are thinking of when we discuss the amendments, were planning for conception six months in advance. They were taking folic acid and vitamin supplements. They were very aware that they wanted to get themselves in the best nutritional shape and best health before they tried to conceive. There is a whole agenda here. It is received wisdom among many people that we should be considering such things and trying to nudge people towards that sort of behaviour.

Stephen Williams: The hon. Lady is right that diet is important. Whether during pregnancy or throughout life, eating healthily is important. Eating fruit and vegetables is a lot cheaper than eating unhealthily by eating burgers or drinking alcohol or smoking cigarettes. I am not sure what the logic of her argument is. I am not sure that giving people £190 extra enables them to do something that, if they had better health education, they could do more cheaply.

Kerry McCarthy: That is a debatable point. I know it has been frequently made in the past, but if one looks at it, it is highly debatable.

Kate Green: Will my hon. Friend give way?

Kerry McCarthy: I will give way to my hon. Friend in a moment, once I have made what will probably be a less erudite response to this question.
If one compares the food on offer in supermarkets, the price of a Tesco value white sliced loaf of bread is incredibly lower than an organic wholemeal stoneground equivalent, and the same is true of many other items. There is also the problem that people on weekly budgets have far more limited choices, because they cannot buy in bulk.

Kate Green: Does my hon. Friend agree that one difficulty with buying fresh produce for people are on low incomes is that they are always concerned about waste? If food is not used each day, they cannot afford to throw it away, and they might have difficulty travelling daily to the shops to buy fresh produce. Does she further agree that the time factor should also be considered, which is particularly important to low-income and hard-pressed families? The time needed to prepare nourishing meals is something that some low-income women struggle to find.

Kerry McCarthy: That is a valid point. Some people might not live within easy access of supermarkets, where food is cheaper. A big issue with rural poverty is that, if people have to rely on local shops, that is much more expensive. They cannot afford the bus fares, or there may be no bus services, to enable them to travel to other places.

Alison McGovern: On that point, would my hon. Friend agree that some of the lowest-income women in my constituency work shifts, which makes shopping a real difficulty? The boost of this money was a real help to them.

Gary Streeter: Kerry McCarthy—on the amendments.

Kerry McCarthy: That is certainly the case. We have slightly strayed off the amendments, although this is a clause stand part debate as well, so we can discuss matters a bit more broadly.
I return to the Minister’s specific points. I look forward to reading through what he and some of his colleagues have said during today’s sitting. It seems to me that completely conflicting points are being used on each amendment. At one point, he says that the health in pregnancy grant is not valuable because it is not paid at 12 weeks, but we have also had a debate about the 12th week not being good either. I do not accept what he says about the open-endedness of it being paid in monthly instalments. I think that the hon. Member for Birmingham, Yardley got confused in suggesting that £190 would be paid every month from the 25th week onwards. The matter was discussed with the Clerks in the Public Bill Office and I made it clear that there would be no extra spending commitment—the £190 would be paid monthly rather than as a lump sum. If the Minister thinks there is something technically wrong with that amendment, he would be entitled to bring something back on Report to make it clear that there is no additional spending commitment and that the grant finishes when the child is born. The fact that it is called the health in pregnancy grant implies that it is paid during pregnancy and ceases to be paid when the child is born. I accept that monthly instalments might create an administrative burden, and there are issues over assessment.
I have cited my hon. Friend the Member for Stretford and Urmston often today, but she has made several valid points. She said that pregnancy can be a factor that pushes women into poverty. For example, if they have not been in a job long enough to qualify for maternity leave, they may lose their job after becoming pregnant, so their financial circumstances would change. If we went down the means-testing route, we would have to do a fair amount of work on how eligibility would be assessed and that might get complicated.

Alison McGovern: Regarding amendment 45 specifically, does my hon. Friend agree that an extension of the grant might allow the Treasury to carry out more work to establish how this grant has impacted on those with the lowest incomes and those who are most likely to see poor outcomes in child health, and that that is perhaps what we should be specifically concerned about at this difficult time?

Kerry McCarthy: That is the case. Although the Minister has praised the Healthy Start vouchers and the Sure Start maternity grant, I think that the Healthy Start vouchers are available only for low-income families—that is the starting point. There is one voucher of £2.80 a week for pregnant women and for children between the ages of one to four, and there are two vouchers of £2.80 each a week for children under the age of one, so people get a little bit more money in the first year of a child’s life. Those vouchers could be spent on milk, fruit and vegetables.
I think that some women on Netmums were saying that some shops are a bit lax about the vouchers and there was some suggestion that somebody could spend them on a bottle of vodka, but again I think that that is a red herring when it comes to assessing the value of such a scheme.
The Minister has said that Healthy Start vouchers are a good thing. In some respects, by saying that he is conceding that giving people extra money to support their nutritional needs is a good thing and it works. Those vouchers are paid to pregnant women too. So we could almost say, “How can you say that Healthy Start vouchers—giving those particular vouchers to women in pregnancy—are a good thing when you are also saying that giving pregnant women extra money isn’t a good thing?”
If the Minister’s problem with vouchers goes back to this issue of not having control over what the vouchers are spent on, can he not concede that at least for the women who are eligible for the Healthy Start scheme—those are women who are given their £2.80 a week in vouchers but who will no longer receive the other £190—it would be a benefit to have that £190 added to their vouchers?

Sarah Newton: I want to remind the hon. Lady that it is not just the Minister who spoke highly about the Healthy Start programme; everyone whom we received evidence from during the evidence sessions and who had experience of the programme spoke very highly of it. The programme is not just about vouchers. There is a range of services, from social services to maternity services to health visitors, that will offer support to those families at this difficult time, which is really important. There is benefits checking, and we have talked a lot about fears of debt. Families will have access to credit union advice. There is a range of services that enables a series of professionals to support a family at the time of pregnancy.

Kerry McCarthy: I agree with the hon. Lady. We are certainly not suggesting that there is anything wrong with the Healthy Start voucher scheme, or that it should be taken away. The point that I am making is that if Government Members think that the Healthy Start scheme is such a good thing, in the impact that it has on nutrition during pregnancy and during the early years of a child’s life, how does that square with taking away an additional £190 that was also going to the beneficiaries of those vouchers? Moreover, why is it not being considered that that £190 should be added to the amount given in the vouchers, just for the people on low incomes? Progress is being made by the Healthy Start scheme and the additional help that it offers to women, but if £190 is then taken away from those women and their families, is there not a risk of undoing all the good that has been done by introducing the Healthy Start scheme in the first place?
I will just run through the amendments that we have tabled. Amendment 44 calls for the health in pregnancy grant to be extended until January 2014 and I think that we have heard very powerful arguments today that we should not rush into axing the grant but rather give it further consideration. We have not heard anything from the Minister to show that the grant is not working and it is important that we have further consultation and really give the policy time to bed down.
Amendment 46 deals with the issue of the 12th week of pregnancy, as does amendment 48. I accept that the hon. Member for West Worcestershire makes a point—an arguable point—about the difficulties associated with that 12th week and I would not want to press those amendments to a vote, because—

The Chairman adjourned the Committee without Question put (Standing Order No.88).

Adjourned till this day at One o’clock.